Information Collection Request

Ambulatory Surgical Center Quality Reporting Program (CMS-10530)

ICR 202102-0938-007 · OMB 0938-1270 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10530 Ambulatory Surgical Center Quality Reporting (ASCQR) Program Form and Instruction Unchanged Repair queued
CMS-10530 AQ 2020-12-29 V1 Supporting Statement B Final.docx Supporting Statement B Uploaded 2021-02-09 Repair queued
CMS-10530 AQ 2020-12-29 V1 Supporting Statement A Final.docx Supporting Statement A Uploaded 2021-02-09 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
214868 Ambulatory Surgical Center Quality Reporting (ASCQR) Program Form and Instruction Unchanged

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved 12/31/2022
672,246 793,699
176,096 200,528
0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Ambulatory Surgical Center Quality Reporting (ASCQR) Program CMS-10530 Data Collection insruments

table that charts list of burden
  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 672,246 793,699 0 0 -121,453 0
Annual Time Burden (Hours) 176,096 200,528 0 0 -24,432 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No